DISEASE MANAGEMENTVolume 10, Number 1, 2007© Mary Ann Liebert, Inc.DOI: 10.1089/dis.2006.628 A Conceptual Framework for Targeting Prediabetes with Lifestyle, Clinical, and Behavioral Management Interventions THOMAS J. BIUSO, M.D., M.B.A.,1 SUSAN BUTTERWORTH, Ph.D., M.S.,2 and ARIEL LINDEN, Dr.P.H., M.S.3,4 Prediabetes is a condition that does not fall squarely into the primary or secondary preven-tion domain, and therefore tends to be inadequately addressed by interventions in eitherhealth promotion or disease management. Prediabetes is defined as having an impaired fast-ing glucose (fasting glucose of 100–125 mg/dL), impaired glucose tolerance (two-hour post-prandial glucose of 140–199 mg/dL), or both. There is substantial evidence to suggest that evenat these blood glucose levels, significant risk exists for both micro- and macrovascular com-plications. This paper introduces a conceptual framework of care for prediabetes that includesboth screening and the provision of up-to-date clinical therapies in conjunction with an evi-dence-based health coaching intervention. In combination, these modalities represent themost effective means for delaying or even preventing the onset of diabetes in a prediabetespopulation. This paper concludes with a brief example in which these principles are appliedto a hypothetical patient. (Disease Management 2007;10:6–15)
